programming their lives may interfere with their work, their
social networks and other protective factors they would
otherwise have in place,” Skeem says.
Increasingly, prisons are using risk-and-needs assessments
to help them decide which services will best benefit which
inmates, says Kirk Heilbrun, PhD, a clinical psychologist at
Drexel University who studies criminal offenders and forensic
evaluation. Several standard assessments exist to measure risk
and need, and take no more than an hour or two to complete,
he says. “Some people need a good bit of support. Some need
relatively little. But we can tell the difference without too much
Yet while correctional systems are getting better at assessing
inmates, there’s still a gap between knowing what offenders
need to be successful, and making sure they get it. “The problem
is people often just stop at risk assessment, and don’t use the
results to inform service provision,” says Skeem.
Often, that gap can be traced to scarce resources, Morgan says.
“We’re doing a pretty good job of identifying needs offenders have
as they’re trying to re-enter society. It’s just a matter of how many
of those needs can be met and for how many offenders.”
And while it’s important to address criminogenic needs, it’s
nearly impossible to do so without first dealing with the more
immediate, basic requirements of everyday life. Morgan recalls
a colleague trying to help a former inmate set goals to avoid
antisocial acquaintances and address his criminogenic thinking.
But the former inmate only wanted to talk about the bedbugs
keeping him awake in the rundown motel where he was forced
to stay after being released from prison. “Criminogenic needs is
a big part of it, but that’s secondary to making sure folks have
their daily needs met,” Morgan says.
Despite such barriers to success, former inmates are often
released back into their communities with minimal assistance
or support. “The mandate of state correctional systems is to
protect public safety, and that charge is frequently perceived
as ending when someone is released from prison,” Peters says.
“There often aren’t built-in mechanisms or incentives for state
correctional systems to work carefully with social services,
particularly behavioral health services.”
As states have begun to recognize the scope of the recidivism
problem, however, some have taken steps to tackle it. From 1999
to 2004, for example, Oregon’s recidivism rate dropped almost
32 percent, according to the Pew report. In Oregon prisons,
inmates receive targeted case management during incarceration,
and detailed reenty planning beginning six months before they
are released. In 2003, a bill was passed by the state legislature
requiring correctional programs that receive state money to be
The federal government has also taken steps to address
recidivism. In 2008, Congress passed the Second Chance Act, a
program that provides federal grants to government agencies
and nonprofit organizations that provide support and services
to people returning from prisons, jails and juvenile detention
facilities. Programs funded by the grant include career training,
mentoring, substance abuse and mental health treatment, and
evidence-based supervision strategies to improve outcomes for
people on probation.
That evidence base is pretty good, many experts say, but it
could be better.
“There’s a fair amount of research on the things former
prisoners need in order to be successful,” says Eno Louden.
“The real gap is in doing randomized clinical trials of specific
programs to really isolate the mechanisms of effectiveness.”
For example, jobs skills programs can reduce recidivism. But
is it skills, such as welding or machine repair, that are helpful? Or
is it the habits gained through the process of employment, such as
showing up and getting along with your boss? Similarly, research-
ers have yet to fully parse which interventions work best for specif-
ic populations, such as juvenile offenders or sex offenders.
Meanwhile, there are opportunities for clinicians, as well as
Incarceration and mental health
• Almost one of every 100 American adults is
living behind bars, a total of about 2. 2 million
people, according to a 2014 report by the
National Research Council.
• An estimated three-quarters of prisoners
released in 2005 were arrested for a new crime
within five years, according to the U.S. Bureau
of Justice Statistics. More than half had been
arrested by the end of the first year.
• More than two-thirds of jail detainees and
half of prison inmates have a substance use
• Rates of serious mental
illness, including major
depression and bipolar
disorder, are three to four
times higher in prisons,
and four to six times
higher in jails, than in the